Qualidade de vida, depressão e modo de enfrentamento do cuidador principal de pessoas com doença renal crônica em hemodiálise

Abstract

Chronic kidney disease (CKD) is a public health problem, characterized by gradual and progressive loss of kidney function to critical levels, where the start of renal replacement therapy is needed to ensure the survival of the patient. One of these methods is hemodialysis, which process is performed on average of 3 times a week, and affects the life of the individual and the family dynamics, requiring many adaptations imposed by the chronic condition and treatment. It is known that the CKD patient has the worst quality of life among the patients with chronic diseases, and in this scenario the main role of caregiver to assist basic needs of life emerges. In this work the objective was to evaluate the level of quality of life, the prevalence of depression and coping way of caregivers of individuals with CKD on hemodialysis, and to verify the association between these variables and describe the sociodemographic and economic profile of the caregiver. Therefore, we performed an analytical, observational, cross-sectional and quantitative study in two dialysis centers, in Sobral, state of Ceará, northeast Brazil. In the set of the study, CKD patients by their own identified their main caregiver; on a second step, after saturation of spontaneous sample, we individually invited each caregiver to attend the hemodialysis service to be interviewed. The final sample included 107 participants caregivers. Data collection took place in the months from July to December 2015 through the SF-36 instrument to measure quality of life, CES-D scale to verify the presence of depression and Jalowiec coping scale to identify the coping strategies adopted. Data were analyzed using the SPSS statistical software with statistical significance set at p <0,05. The results pointed to a prevalence of female caregivers, comprising young adults, coming from municipalities near Sobral CE, from low social class without labor activity with predominance of family relationship: sons/daughters, spouses or parents. Quality of life was most affected in the social aspects. It was identified a high prevalence of depressive symptoms (71,9%); the use of emotion-oriented coping was quite prevalent and was validated as a predictor of depression, with risk increased by 20% for its occurrence. We observe the need for adequate health care for these caregivers, since when doing this role they become susceptible to major changes in their quality of life and health, especially mental